PROJECT SUMMARY The vast majority of research conducted in children in the United States (US) today does not include children living in the 24 IDeA eligible states/territories identified by the NIH such as Arkansas. Consequently, findings may not be generalizable to a substantial proportion of children who carry the highest disease burdens such as obesity, diabetes, pre-maturity, lung and neurodevelopmental disorders. Future therapeutic and non- therapeutic trials must be available to these children if their health status is to be improved. Arkansas Children's Research Institute (ACRI) is prepared to immediately address the overarching program goals of the IDeA States Pediatric Clinical Trial Network (ISPCTN) and thereby, work to close the ?clinical trial gap? for children living in IDeA states. To this end, we have formed the Arkansas Center for Advancing Pediatric Therapeutics (ArCAPT). Our efforts will be directed by the central hypothesis that ArCAPT will enable the participation of diverse groups of infants, children and adolescents in expertly designed, innovative clinical trials of the highest quality and scientific value. We will leverage our unique patient base, intellectual capital and established inter-institutional resources to enhance pediatric clinical trials funded by the NIH and other supported research. Our established clinical trial enterprise and cadre of senior pediatric clinical investigators will enable us to explore the impact and intersection of ontogeny, environmental exposure and disease in four high priority areas: upper and lower airway disease; obesity; neurodevelopment and pre-, peri- and postnatal development. Our hypothesis will be tested by executing three specific aims: 1) Link established inter- and intra-institutional resources supporting pediatric clinical trials. We will partner with Arkansas Children's Hospital and the University of Arkansas for Medical Sciences to increase the scope of pediatric trials, address the impact of racial and ethnic minority health issues and the intersection of environmental factors and disease as they relate to therapeutic endpoints. 2). Provide supervised professional development in research and clinical trial implementation. We will maintain and expand our existing clinical research teams and train the next generation of pediatric clinical researchers through high quality education in the conduct of pediatric clinical trials. 3). Create a state-of-the-art clinical trial platform for infants, children and adolescents. Using a cross-disciplinary team involving multiple pediatric subspecialists, we will expand clinical research and test and validate new technologies, tools and approaches for evaluating the interface between race/ethnicity, ontogeny, environment, disease and treatment response. The outcome of this proposal will improve the health of children of Arkansas and beyond by systematically addressing the unique health challenges of IDeA state populations.